Standing Committee A

[Mr. David Amess in the Chair]

Clause 8

Limited capability for work

Danny Alexander: I beg to move amendment No. 171, in page 7, line 6, at end add—
‘(7) A person authorised to exercise the functions in subsections (2) and (3) may be required to undergo such training in relation to claimants with particular impairments and health conditions as the Secretary of State may by regulation require.’.
It is a pleasure to serve under your chairmanship once again, Mr. Amess, and I am looking forward to continuing these debates in the positive spirit in which they have been conducted so far, especially, if I may say so, from the Government Benches, from whom the only party political remarks we have heard have come.

Hon. Members: Oh.

David Ruffley: It’s a pilot scheme for being nice.

Danny Alexander: I notice that the hon. Gentleman on the Tory Front Bench, from a sedentary position, seems also to be engaged in a pilot scheme of being nice—he is managing reasonably well so far. No doubt, however, we shall be able to get some more rancour into the debate as the week goes on.
Amendment No. 171 would allow the Secretary of State to require those carrying out assessments of claimants with particular impairments or health conditions, in relation to limited capability for work, to be trained. The amendment probes the Government’s intentions in that area. Given the range and complexity of disabilities, impairments and health conditions that might be encountered in the assessment process, as described in previous debates, it is important to ensure that assessors have the required degree of training, knowledge and understanding of the full range of those conditions or impairments.
It is interesting to note that in some cases specialist nurses are used already for assessments in relation to disability living allowance, specifically to ensure that specialist knowledge is brought to the assessment. By contrast, however, personal capability assessments so far have relied exclusively on general practitioners, but it is widely believed, particularly by disability lobby groups, that GPs’ knowledge of some conditions or impairments might not be sufficient to make a reliable assessment. The amendment would empower the Secretary of State to order such training as might be necessary to bring them up to speed.
Currently there are no statutory obligations for training for medical assessors in relation to certain disabilities, particularly in relation to mental health conditions, learning disabilities and so on. A higher level of understanding of those non-physical conditions would help to reduce the current high level of appeals and their high success rate. For example, in 2003 nearly 48 per cent. of appeals against the refusal of incapacity benefit were successful; indeed, 68 per cent. were successful when a citizens advice bureau or other adviser with expertise in the appellant’s condition attended the appeal. In many cases, the lack of knowledge of the nature of the condition or impairment at the initial PCA is cited by appellants as a reason why they think that the first decision was wrong. The amendment aims to bring more specialist knowledge to the PCA.

Tim Boswell: The hon. Gentleman will not be surprised to hear that I am very much sympathetic to the lines of his argument; they are entirely congruent with what we have heard from disability and other organisations over the years.
Would the hon. Gentleman accept that there are two practical problems with his amendment? First, in relation to multiple conditions, is it possible for any one examiner to have the sufficient range of knowledge to be able to embrace all the difficulties and their interaction? Secondly, in order to produce the full range of expertise it might be necessary to have a panel of people examining simultaneously, which could be extremely daunting for the claimant.

Danny Alexander: The hon. Gentleman makes two very good points. Of course, it might be asking a lot for the same doctor to have expertise in every single potential condition, impairment or disability. That is a valid point, and if the answer was to have a panel of people who a claimant might appeal to, that too might be intimidating. It could also reinforce some of the biggest problems with the assessment process at the moment.
With regard to disability living allowance, specialist nurses can be called upon where someone with a particular condition is presenting. Bearing in mind that in the application for employment and support allowance the applicant has to spell out their reasons, it should be possible to predict with a large degree of accuracy the cases in which some form of specialist input might be useful. That could mean either ensuring that the doctor who is carrying out the assessment has the requisite skills, knowledge or understanding or,if they do not and if no one in that particular locality has those skills and experience, making sure that another specialist doctor or a specialist nurse could be brought in.
I am not seeking to create an unnecessarily burdensome or intimidating assessment procedure. What I am seeking to probe is the extent to which the Government consider it important that specific knowledge of health conditions or disabilities is included in the assessment process to ensure that it is accurate. This is also important in relation to fluctuating conditions, particularly those, such as MS, where specialist knowledge of the condition may be useful in carrying out an assessment.
Particular representations have been made to me in relation to people with autism or autistic spectrum disorders. According to the National Autistic Society, 40 per cent of GPs do not have enough information to make informed assessments in relation to disorders on the autistic spectrum. It is worth noting that only 6 per cent of people who are autistic in some way are in employment. That is an incredibly low figure compared with 49 per cent for disabled people as a whole. This may, therefore, be an area where having a degree of specialist knowledge throughout the assessment process would really help to add value at all stages. I shall be grateful if the Minister will address that point specifically in his response.

John Robertson: The training for assessors has been brought up in the past and I know that Mr. Hood said that we would not have any stand part debate on this clause, so I feel that this is a good point to raise it.
Training in general terms is a concern of many bodies that represent people with disabilities; the fear is that a general practitioner would be given a job as an assessor with absolutely no knowledge of some of the problems suffered by the people that they would be assessing.
Can my hon. Friend the Minister allay my fears on that, and maybe go into some detail on the training for assessors? Can he also clarify the point on collation of information? I mentioned that when we debated an earlier amendment. It is important that he reiterates the fact that we would pull in all information and, if all the information were not available, we could go back over it a second time to gather any missing information.
The hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) makes good points about the fact that it may be necessary to bring in more than one expert for discussion. I would like to know what sort of liaison is carried out in relation to talking to the medical experts, whether they are, for example, experts on injuries or on mental health.

David Ruffley: Welcome to the Chair, Mr. Amess, on this grey morning—not as cheerful as the other days when you have been in the Chair.
I would like to tease out from the Minister a couple of points which bear on what the hon. Member for Glasgow, North-West (John Robertson) has just said. On the question of the types of people who would be doing the assessing, the Secretary of State in evidence to the Select Committee in the Spring this year said,
“my understanding is that people agree that we should involve the skills and expertise of a wider relevant range of healthcare professionals to help us do this.”
“Wider” implies wider than is the case under the current regime. He went on to say:
“There will be a list of people, I am sure, occupational therapists and physiotherapists and others, but who actually is involved in individual assessments I think is going to have to be something we discuss with people over the next few months.”
That is fair enough; the Secretary of State says that a wider range of specialists and professionals will be involved. I think I know which group polices and executes the conditions under the current regime, but it would be extremely useful, given that the Secretary of State was generous in saying that he would consult on involving a wider range, if the Minister could give us some information on that.
That brings me to my second point. Does it trouble me? I do not know—it niggles a bit at the back ofmy mind. In evidence to the Select Committee,Dr. Boardman of the Royal College of Psychiatrists, who gave a lot of evidence for the excellent Select Committee report on the pathways programme, set a hare running—certainly in my mind, if a hare can be set running in a person’s mind, and I think other people were also worried—on the question whether there would be enough people to carry out the wider assessments. Obviously, there will be more varied assessments under provisions in these clauses than under the current regime; we all know that.
The idea was floated that lay people could be trained to carry out the mental health assessments, which is an interesting idea. The reason I want the Minister’s view on that point is that Dr. Boardman is very distinguished and a bit of a player in incapacity benefit reform. He said to the Select Committee that
“it is quite possible, for example, to train anybody to do a perfectly good interview with somebody with a mental health problem and come up with a reliable judgment. This is used in research all the time. When we look at the results, say, of the OPCS survey of Psychiatric Morbidity in Great Britain, a national survey, this was all done by lay interviewers using a particular form of structured interview.”
I do not know what is in the mind of Ministers but that distinguished psychiatrist raised the possibility of lay people carrying out mental health assessments. I do not have a preconceived view, but I would be interested to know whether the new regime will recruit lay assessors for the mental health component of the tests that we are considering.
My final point relates to observations fromSue Christoforou and Mind. I shall quote, becausethe quotation raises powerfully the main issue of this amendment and a theme that is a leitmotif of the whole Bill. We have personal advisers under the pathways programme and we will have personal advisers under the new regime, but do they and will they have enough training? Later I hope to show that the advisers themselves do not feel that they have enough of a skill set to be able to do the extra things required of them under the new regime.
Mind said:
“The majority of doctors who carry out PCAs”—
this is under the current regime—
“will be locums. Most will be GPs who have done a day’s work and will do PCAs in addition.”
This is Mind’s view; I am not necessary impugning all those who work with and for Atos Origin. I have seen a simulated version of Atos Origin’s PCA in Woking and it seems to be a professional company.
“They do get some condition-specific training but it is very limited. They certainly do not have much in-depth knowledge of mental health problems in the experience of our”—
Mind’s—
“advisers who work with people with mental health problems.
I spoke recently to one of our welfare rights advisers. She attended, I think, 50 PCAs with various clients and in only one case did she find the person to have any understanding of what the issues were, to treat the person with respect, and to conduct the assessment at a pace that could give the person the opportunity to discuss as much as needed to be discussed in order for the assessment to be thorough. So I think, given that40 per cent. of people in receipt of incapacity benefit at the moment have a primary diagnosis of mental health problems, not to mention whatever per cent there is of the rest of the caseload who have a secondary diagnosis, it has to be the case that the doctors conducting PCAs have to have a thorough, possibly NVQ level three mental health training at the very least, as indeed should decision makers, in order to make proper judgments.”
We are talking not about decision makers here, but about the cutting edge assessment that is the subject of the clause and the amendment. I certainly know from one of the Department for Work and Pensions reports on evaluation of pathways that the NVQ level 2 was the average for incapacity benefit personal assessments. An NVQ level 3 in mental health is being asked for here.
Those observations may be partial. Perhaps Atos or Ministers will dispute what Mind has said, but it is an interesting debating point which relates to the amendment. I should be grateful if the Minister responded to that point. I have no idea whetherDr. Boardman’s suggestion that lay people can be trained to do mental health assessment is sensible or not, but it would be useful to hear the Minister’s views on that and on the point that the Secretary of State raised in evidence to the Select Committee.

Kali Mountford: Good morning, Mr. Amess. Earlier in our deliberations the Minister outlined a process whereby, at the early stages of an assessment, a paper sift would be possible. I have been looking at cases in my constituency and at the level to which the NHS can now treat conditions that hitherto were untreatable. I cite the case of a woman in my constituency who was horrifically attacked. She was unfortunate to be attacked but lucky to be alive, given the extent of her injuries. She would like to work now but, unfortunately, the consultant vascular surgeon who is treating the injuries to her brain says that she would be ill advised to do so because he has been able to stabilise her only enough to be at home, not to be able to go out to work.
Under the current system, people looking at my constituent and answering the questions would assess her as suitable to work because they would not look closely enough at the consultant’s advice. I want the new process to take account of such clear advice from a consultant that someone would be harmed by going through the process, and that the injuries are such that it could be a threat to their life if such a process were to continue. We should all be assured that the almost daily advances of medical science can catch up with the process that we are trying to deliver for another part of someone’s life.

Tim Boswell: I should like to add one or two comments to this extremely interesting set of exchanges and questions for the Minister. If one looks at the rubric of the clause it seems to be about limited capability for work, which is a kind of lay assessment that, on the other hand, requires professional expertise to provide the gateway. I think that trying to blend those two concepts is inherent in some of the comments made already and, indeed, in the difficulties that the traditional PCA system has met—the high level of appeals and so forth. That is not because assessors are wicked or malicious people proceeding in a hurry, but because their job is inherently very difficult.
My comments are informed by my now dated experience of being responsible for the disability brief, and by when the Department kindly arranged for me to visit Atos—or rather its precursor, Schlumberger—to observe how it trained its assessing doctors. One day, I sat in on a session. I went with some trepidation because I thought, as a lay person, “What on earth can I do?”, but, by the second hour of the process, I realised that essentially we were in the same job—I did not see theirs as being very different from mine or, indeed, any other Member’s when dealing with a constituent at an advice bureau or surgery, depending on what we call them. The job involved putting people at ease, enabling them to express themselves and forming a general view of their condition. That is a stream of the matter.
As I and others in Committee have said before, the ability to encourage claimants or customers—call them what we may—to act positively and to express themselves authentically is an important part of the process. However, the assessment is a gateway to a benefit, so it is perhaps understandable that it should require a professional framework, particularly for the physical side. Historically, the IB process has been driven primarily by physical conditions, such as muscular skeletal or circulatory problems, but now it is largely informed by people’s mental conditions. I am saying not that too much emphasis is placed on mental health, but that anything that might lead to a clinical illness is examined—the claimant might just lack confidence. Tuning that change is a difficult part of the process.
I suspect that somebody will ask me to comment, albeit briefly, on my visit last Friday to the pathways to work pathfinder in Derby. Members were aware that I was going, and I found it a positive experience and quite encouraging. However, I came across some information about the mental health aspect which made me think, “Well, I have not really focused on this before.” Conventionally, it is said that some 40 per cent. of benefit claims fall within the mental health framework, but if we include secondary mental health effects—for instance, for people who have a physical condition such as back pain that has consequences for how they feel—we are probably looking at two out of every three claimants. So that is a very big part of the matter.
This is a proposition not a conclusion: the Minister should address the fact that more people are presenting a series of mental conditions, which are inherently less easy to measure, and indeed, doctors are often less equipped to deal with them than with somebody who has, say, a limb deficiency or circulatory problems.The situation is becoming more difficult. The tests encourage people to show their capability for work, not whether they have a series of finite medical conditions that would make work impossible.
That is a complex and difficult matter. My exchange with the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) was designed to eliminate some of the practical difficulties. Does one have a full suite of people taking account of allthe circumstances? Is the cure for that lack of omnicompetence worse than the disease of not being omnicompetent? Those are difficult issues for the Department.
I add one more thing. I suspect that there might be a medical test here. It would fall outside the Committee’s remit to ruminate on whether the law, and in particular the growth of administrative law, has helped the nation’s commonwealth, as it were, or impeded it. It is certainly very good for the lawyers—a member of my family is a practitioner in that area—but I am not sure whether it adds to the sum of human happiness.
One of the difficulties, if one uses lay people, is that the nature of their assessment and the appropriateness of their training become directly relevant. There is a certain expectation about an examining doctor who has been registered with the General Medical Council and who meets certain professional standards and indeed professional commitments and duties. No matter how they behave, and they normally try to behave in a highly professional manner, they have at least some cover for their position. If, on the other hand, one uses a barefoot doctor or a lay helper on the medical health side, however well intentioned and however well skilled, it may be that they do not have the kind of professional coverage that would prevent them or the Department from being challenged in court. These are serious issues that the Minister and his Department need to address.
Where we go from here should be informed by one simple test. We need to be able to assess people’s capacity for work in the round. We need to do it in a way that is positive and sympathetic and emphasises their capacity and not what they cannot do. That is going to require a rather broader and more holistic approach than we have had hitherto.
I rehearse one more point as the Minister might like to say something and I do not want to make it seem banal by leaving it till the end. As he will know, and indeed I have asked questions of the Department, there are now logic-driven protocols as to how to do assessments. He has referred to the number of points that is required to pass, or fail, the test, according to the way one looks at it. I do not think this is wrong as long as it is not seen as being a literal-minded exercise. It is a guide to good decision making. Perhaps he could say a little about the use of protocols. Also, how is this being mapped on to the experience of GPs who are referring persons for incapacity benefit or writing them sick notes? We need to have in these complicated areas a better understanding of the process. We need people to know what they are talking about, to be able to exchange information professionally in the right way and to have the right training to carry out assessments.
I am sympathetic to Ministers as they try to pick a way through that and I would be even more sympathetic if they could reassure us that logic and protocols will be used as a servant and not as a master in the process. The underlying principle should be to support, identify and celebrate the capacity of the individual rather than to conduct some penal exercise.
I am sure the word on the street is that the exercise is designed to take people off benefit at all costs. I know that that is not the Minister’s intention, and it is certainly not our intention or that of anyone in the Committee, but the process has to be fair and in the end fairness is probably how this will stand or fall.

Jeremy Hunt: May I too welcome you back to the Chair, Mr. Amess? It is a pleasure to serve under your chairmanship, which, in the best spirit of the employment and support allowance, has been light-touch and supportive, with minimal use of sanctions.
I think that this is an important amendment because, on the face of it, it is not a matter of law at all. The reality is that the Secretary of State does not need regulations passed by this House to insist on proper training for people who carry out the assessments or indeed for Jobcentre Plus personal advisers.
I am grateful to the hon. Member for Inverness, Nairn, Badenoch and Strathspey for tabling the amendment because it allows us to draw attention to an important failing in the current system. I ask the Minister not simply to deal with the point of law and whether the amendment should be covered by the regulations, but to address the wider issues that have come up, put most eloquently by my hon. Friend the Member for Daventry (Mr. Boswell). In particular, I draw the Minister’s attention to some comments by the Citizens Advice Bureau. It says that it has
“particular concerns about the ability of Job Centre Plus personal advisers to appropriately and accurately identify the support needs of people with fluctuating and unpredictable conditions or those whose conditions are likely to get progressively better or worse over time.”
It continued:
“Customers with mental health problems were seen as particularly challenging and ever more experienced advisers did not feel confident working with them.”
That was according to recent DWP research. There is clearly an issue about the training of Jobcentre Plus advisers, and if it is important for those advisers,it is doubly important for those who perform the assessments.
My hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) and I held a seminar in which we invited representatives from disability organisations to talk about welfare reform. One very moving submission came from a lady who had a bipolar disorder. Hers was a fluctuating condition and she said that when she went through her PCA, she felt obliged to “ham it up”—her words—because although at the time she might have been feeling fine, she had little confidence in the assessor understanding how a fluctuating condition works. She was worried that unless she pretended to be suffering at that moment, she might not get the right assessment.
Yesterday, I was in Sheffield and I met a man with a learning disability who said that his biggest fear about the assessment was that the assessors did not really understand the concept of hidden disability. It is easy to grasp the disability of someone in a wheelchair, but harder if the disability is hidden. I draw particular attention to the comments of my hon. Friend the Member for Daventry and the hon. Member for Colne Valley (Kali Mountford). This is a hugely complicated area; it is particularly difficult to grasp the difference between a learning disability and a mental illness. A lot of people with learning disabilities also have a mental illness, but it is crucial, if there is to be confidence in the system, that assessors understand that difference and know what can be sorted out by the NHS and what is a long-term condition.
My hon. Friend the Member for Bury St. Edmunds made the point clearly that we do not want the debate to descend to the level of tabloid arguments about welfare scroungers. If the assessment does not have credibility, and if the ability of assessors to accurately determine whether someone has a hidden disability and to discriminate between that and mental illness is not absolutely rock solid, we will give ammunition to those trying to discredit the whole process.

Natascha Engel: I do not want to make a speech, so I shall keep this to an intervention. What the hon. Gentleman said is very important, especially on the distinction between a mental illness and a learning disability. However, there is no way in the world that national legislation or even local practice can ensure that those will always be correctly identified. There is absolutely no way of doing that. It is important, however, that this legislation involves organisations with expertise in the identification of those differences and includes them in the assessment phase in order to deal with claimants and show them where to go so that they can access the help that they need. That is what the hon. Member for Bury St. Edmunds was talking about—a more holistic approach. Rather than using lay people, we should bring in organisations—

David Amess: Order. The Committee is delighted to hear the hon. Lady, but I think that that did turn out to be a speech.

Jeremy Hunt: I am grateful to the hon. Lady; she made an important point, enthused, I am sure, by her work on the Select Committee.

Tim Boswell: As we look forward to the use of contractors in pathways, which my hon. Friend and I would be happy to accept as a principle, is it notalso extremely important that there is also some commonality of understanding as to the availability of expertise and practice? Although the contractors are responsible for their areas, they need to operate within the same general framework so that the test is not merely seen to be fair nationally, but is also seen to operate evenly and fairly between different localities.

Jeremy Hunt: My hon. Friend makes an excellent point. I do not want to prejudge what the Minister says, but I suspect that the fact that this test is conducted by contractors gives the Secretary of State the opportunity to include any training requirements into the contractual stipulations, and that would probably preclude the necessity for legislation or regulation. I completely agree with the comment of the hon. Member for North-East Derbyshire (Natascha Engel) that no national legislation can deal with the complexity of these issues.
All I ask the Minister to address is not the legal point on this amendment, but the substantive point of the very real concern about the understanding of hidden disabilities, in particular among people performing the PCA as it is now or the revised PCA and, indeed, among Jobcentre Plus personal advisers. If this programme is to be successful, there is no doubt that this issue needs to be addressed.

Jim Murphy: Good morning to you, Mr. Amess, on this rather dreich morning that we are enjoying in SW1. I am delighted to see you with us again.
To respond first of all to the comment by the hon. Member for South-West Surrey (Mr. Hunt), by necessity, I have to respond to the legal and technical sense of the amendment, but I am happy to respond also to the common-sense comments. I accept it is a probing amendment, but let me explain why it would not be legally necessary. All health care professionals undergo such training as designated by the Secretary of State that he or she considers to be appropriate before they are approved to carry out medical assessments to determine limited capability for work. With regard to the specific suggestion that we place this provision in regulations, we cannot as a Committee, a Government or Parliament micro-manage every intervention and interface between a health care professional or a health care practitioner and each of the customers. To put it in regulations would be generally accepted as impractical. It would leave us sluggish and with an inability to respond to ever-changing circumstances. It would also fly in the face of so much else we are trying to do in terms of empowering personal advisers and ensuring that at a local level a situation evolves and changes quickly enough to be able to support people regardless of their circumstance or condition.
The Secretary of State has the power to designate what would be appropriate training and also the appropriate support that either assessment staff or personal advisers should undertake and offer to customers. As this has proven through pathways to be an effective way to operate, I think that it is the best way to proceed. I hope the hon. Gentleman accepts the strictly legal point that we have the power at the moment and that this power is entirely flexible and enables us to respond to evolving circumstances.
I will try to respond in the time available to the 25 or 27 questions that were asked, but if hon. Members do not think that I have done so they can intervene or we can take it up further in our proceedings.
To respond to the point made by the hon. Member for Inverness, Nairn, Badenoch and Strathspey, it is absolutely clear—we said it on Second Reading and we say it again today on the record—that, as we change our ambition, in trying to support people who in the past have been written off, and on the basis that we are not being party political at the moment, let us just say that they were written off for whatever reason by —[Interruption.]

Jeremy Hunt: Successive Governments.

Jim Murphy: I have been provoked.

David Ruffley: If I could help the Minister out inthe spirit of consensus, may I ask whether a drafting suggestion would be acceptable? Successive Governments up until and including this one have, regrettably, tended to write off those who have been furthest away from work. All politicians of all parties should acknowledge that they have not performed as they should in helping those people. We should all celebrate that acknowledgment on both sides today in Committee. Does the Minister agree?

Jim Murphy: I do not wish to try your patience, Mr. Amess, by making this point: I would not accept the amendment, but I would accept that successive Conservative Governments deliberately allowed people to be written off.

Jeremy Hunt: This is not a profitable line to go down. Our response to the Minister will simply be to ask why, if the problem was so serious, the Government waited eight or nine years before doing something about it.

David Amess: Order. I appeal to the Committee to get back to the amendment.

Jim Murphy: You are right, Mr. Amess.
The amendments are about how we support the2.7 million people who are on incapacity benefit. Pathways has been exceptionally successful. The funding for pathways was not entirely consensual. I know that the hon. Member for South-West Surrey was not here and did not have the opportunity to vote against the money for pathways, but if he had been, he would have had the same opportunity as his hon. Friends.
We are having a conversation about the future and how we support the 2.7 million who are on incapacity benefit. If no action had been taken in recent years, that figure would be 4 million. The trajectory through the 1980s, half the 1990s and up till now would have put that figure at 4 million. I say that simply because I was encouraged to do so by the hon. Gentleman on the basis that it is important to have consensus about the future. However, let us not forget that people on incapacity or equivalent benefits have not been supported as they should have been and that is across Governments. There was a genuinely dark period for about 10 years, when as a matter of public policy, incapacity benefit numbers were allowed to treble.
We can leave it there if hon. Members wish, or we can continue the conversation. It is nevertheless a statement of fact that incapacity benefit numbers trebled over that period. Nothing different was happening in the environment. We did not have a sudden outburst of a certain condition or ailment. There was nothing different in our air, our water or our food chain. The numbers simply trebled. We can discuss why that happened.

Jeremy Hunt: May I encourage the Minister to return to what he is seeking to do in the Bill? If he wants to talk about what happened under the previous Government more than nine years ago, we will feel obliged to respond. We interpret those events differently, but I do not think that it is a good use of the Committee’s time to rake over those arguments. We certainly do not want to have that discussion—

David Amess: Order. I appeal to the Committee for the final time. I ask Members to return to the amendments.

Jim Murphy: Thank you, Mr. Amess. I will do exactly as you suggest. Perhaps we will continue that conversation another time, perhaps even in another place. It is important not to forget the past so that we can avoid repeating the mistakes.
Returning to the consensual tone of five minutes ago, the hon. Member for Inverness, Nairn, Badenoch and Strathspey asked about specific support. I was in the middle of saying that if we are to achieve the ambition that we all now share to cater for those2.7 million customers, with their various conditions and complicated and multifaceted needs, and for ESA customers from 2008, we will need to change the training in Jobcentre Plus and Atos Origin. When pathways is rolled out nationally, we will need to change the training given to personal advisers through the private and voluntary sectors. We will need to change the way in which all our agencies—not just the DWP, those to whom we subcontract and Jobcentre Plus, but other aspects of the Government, including the health service—make support available.
Quite fairly, the hon. Member for South-West Surrey mentioned the Citizens Advice briefing on the clauses and amendments before us. It says:
“Citizens Advice therefore recommends that adequate resources and training be provided to personal advisers to ensure that those in the support group who chose to participate in work focused interviews are able to do so in a meaningful way.”
I agree absolutely with the thrust of that quote. Of course, it is about a specific group of customers, but the general thrust—that we need to provide personal advisers with adequate resources and training—is entirely fair. We are addressing that point, which the hon. Member for Inverness, Nairn, Badenoch and Strathspey raised in his amendment.
I was asked specifically about autism.
Mr. Boswellrose—

Jim Murphy: I would like to make some progress before I give way.
I was asked specifically about autism, which is another example of what we are talking about, although there are many others. We will all have come across such examples as constituency Members of Parliament and in preparing for these deliberations and we will all have met people and listened to their experiences. Entirely fairly, the National Autism Society put it me that a personal adviser who does not have knowledge or experience of supporting people with autism could mistake a customer with autism for someone who was being unco-operative or even belligerent, and think that they were failing to participate. We will ensure that that important point and others that are made to us feed through the process. Indeed, that is why, in preparing for the revised public consultation, I and the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Stirling (Mrs. McGuire), ensured that autism groups could join some of the technical working groups in which they had not taken part before. We did that to ensure that we were sensitive to the autism spectrum.

Tim Boswell: It just occurs to me that the Minister might like to comment on the fact that there are also quite strong management and organisational implications for the Department. Much as we want outreach—it will certainly be important that rural areas are also covered—it is equally important that the body of expertise in a pathways area or its successor, whether contractorised or in the Department’s capacity, should draw on the advice of specialists with background knowledge of the individual that is appropriate to the case.

Jim Murphy: I welcome the hon. Gentleman back from his sojourn in Derby and I am delighted to see him back in his place. He is right in the sense that it is important, certainly when subcontracting, that we bring in niche experience and niche service. I will not say which organisation might be involved, because Ministers are, quite rightly, not involved in the contracting process.
Let me step away from the matter of autism for a moment, however, and deal with the general point. I recently visited constituencies in west central Scotland to listen to the experiences of people in pathways and on long-term IB. I had the sense that trade unions, for example, which had previously represented and supported the work force in heavy industry—there is no longer any heavy industry in that community—and which had campaigned for their members while they were in work, could bid for some of the contracts to support people in pursuing their right to work now that they were out of work and had been on IB for a long period. Such people might have been on IB for10 years, but that does not preclude a trade union from becoming involved in providing the support for work-focused interviews that will get people closer to the labour market. In talking about private and voluntary sector pathways, we have not yet properly discussed the role of trade unions and other progressive organisations and charities in the voluntary sector in supporting people using the relationship of relative trust that exists already. That would be important.

Tim Boswell: In the spirit of the Minister’s remarks, does he not agree that it should at least be open for a consortium or partnership that may well involve some of the groups that he mentioned as well as the private sector or other representatives to make a joint bid?

Jim Murphy: The hon. Gentleman is absolutely right and we are looking at ways in which we can further devolve that contract, so that a group of organisations from the public, private and voluntary sectors can work together and say, “In and of ourselves, we could not provide this, but collectively in this area we think that we could”. That would be an important and welcome departure from the current situation.

Jeremy Hunt: If I may, I should like to return to the substance of the clause, which is about the training provided to assessors. With the indulgence of the Chair, we widened the debate to include Jobcentre Plus personal advisers in general. I think that the Minister said that he recognised that something needed to be done and that plans are afoot. Will he give us details about those plans?

Jim Murphy: I think that Jobcentre Plus staff undergo 13 weeks of initial training and are encouraged to undertake further training. However, it is clear that, by 2008, Jobcentre Plus will not be undertaking PCAs—indeed, in most cases it will not be undertaking five of the six work-focused interviews. It will be conducting only the first of them, in most instances.
Despite the fact that the role of Jobcentre Plus is changing, it will remain an important organisation; it will still come face to face with most customers—although probably only once because the other five work-focused interviews will be conducted by the private and voluntary sectors. It will meet people with different experiences. Many people at Jobcentre Plus have already undertaken excellent training and done fantastic work on pathways. Indeed, the success of pathways is due in part to the skills that many people at Jobcentre Plus have that enable them to support claimants. The hon. Member for Daventry saw that for himself only last week.
Between now and 2008, on the basis that Jobcentre Plus will see all sorts of people who until now it might not have, and be expected to provide them with support and advice that until now it has not been expectedto provide, the training will have to be adjusted accordingly. I do not have a set of prescriptive solutions that state exactly what will happen in 2008. Jobcentre Plus’s training will adapt to the demands of ESA in 2008 and we will work with its senior managers to ensure that that does happen.

David Ruffley: I do not want us to career off into the realm of personal advisers just yet because we will get to that later.
I think that the amendment relates to the skill levels of assessors involved in the reformed PCA, and the work-related activity and work-focused health-related assessments. I would be grateful if the Minister responded to my point about the wider range of professionals at the new reformed PCA stage that the Secretary of State was talking about in March. What level of training will they have?

Jim Murphy: With your indulgence, Mr. Amess, I shall come on to the content of the amendment. We can pick up on the wider points about the training of personal advisers later in proceedings.
The hon. Gentleman mentioned comments by Mind—both his and Mind’s intentions were fair, I know—but Atos Origin has 273 full-time doctors. As he knows, it is not a hotch-potch of part-time GPs doing extra shifts. It has 273 full-time doctors. GPs who work half-day a week as part of their involvement in the assessments have to undergo similar refresher training to doctors at Atos Origin. As he accepts, those doctors do not do it for some overtime, as is also the case with Mind.
The specifics of training Atos Origin and other health care professionals relate to the point made by my hon. Friend the Member for Glasgow, North-West. They will receive training in disability analysis, which of course requires different skills, by 2008. The training includes aspects of clinical medicine, the gathering and evaluation of evidence and report writing. We know from our constituency experience that report writing has improved in recent years, but how the reports are structured and what is in them is still a source of friction. The language must be understandable to people with no medical background or experience, particularly those with fluctuating mental health conditions. There is also training in general customer care issues such as equal opportunities, how to handle or avoid complaints and how to carry out assessments sensitively. I believe that those undergoing the training also have to undertake four additional modules a year, and as we move towards 2008 we will assess whether that is the appropriate number.
On a point that my hon. Friends have raised, health care professionals will be expected to access additional information through the new PCA when appropriate, perhaps from a local GP or increasingly from other health care professionals in the community—psychiatric nurses and others—who have a relationship of trust and knowledge with customers and experience of them that an Atos Origin doctor might not have. That is the sort of additional information that the Secretary of State alluded to.
We will ensure that the technical groups keep the revised PCA under review so that it is fit for purpose, particularly on mental health, and is achieving what we want. That is on top of the commitment that we have already made that the PCA will run alongside the current PCA, so that there are no unintended consequences.
I have responded to the points that my hon. Friend the Member for Glasgow, North-West made on additional medical experts. In an earlier sitting, he asked how we will gather relevant information, on time, that is clear enough for decisions to be made. My response was that we will ensure that there is an additional phase of reconsideration. We will not simply gather information and come to a judgment that might be wrong because not all the relevant information has been provided, asked for, or provided in the right way to enable an informed decision. The move towards reconsideration in advance of any appeals process will ensure that decisions are right the first time round and based on accurate information. In response to the hon. Member for Bury St. Edmunds, it is important to say that the chief medical officer, on behalf of the Secretary of State, agrees the content of the training syllabus and the materials used. That will provide an additional opportunity for technical and professional input as we move towards 2008 and the employment and support allowance.
The hon. Gentleman also mentioned the comments of Dr. Boardman. Neither the hon. Gentleman nor I are medically qualified, as Dr. Boardman is. I believe that his suggestion would be difficult to carry out, but a number of people have argued the case for training others to provide the mental health support that folk require. For example, yesterday I met representatives of the Scottish Association for Mental Health, who said that they wanted to find different ways to support people with mental health issues. They mentioned their own pilots, whereby the association, or those working on its behalf with mental health experience, can support people without needing three or four years of medical training. I did not commit that that is where we wish to be; I said that we should continue the conversation to see whether it is a valuable route for us to continue along.

Tim Boswell: This possibly answers or anticipates the Minister’s answer to my specific question about what might be termed the legal cover for this exercise. Should a possible model be that the assessment process—it will be a process rather than a spot event in many cases—is monitored or signed off by a medical practitioner, drawing on information that others, who might not be formally qualified but who are appropriately trained, bring to that assessment?

Jim Murphy: On the point made by the hon. Member for Bury St. Edmunds, the issue is to continue that conversation to find out the most appropriate way to support people with mental health experience. I am happy to have that conversation with him and others.
On the specific point made by the hon. Member for Daventry, through the PCA and the revised PCA a medical health practitioner would carry out the assessments, so technically they would sign off the assessment. It is important to put that on the record. However, they would not make the decision. They would make the assessment, but the decision maker would make the decision. Hopefully that reassures the hon. Gentleman that a medical professional would be involved in the assessment.

Tim Boswell: I am grateful to the Minister for that assurance. Does he not also agree with something that I have gleaned from my experience from Jobcentre Plus: when the decision maker considers the report of the medical practitioner in a PCA case even now, it is not so much that they hold up their hands and say, “The whole thing is wrong medically” but that they refer it back? There is then a dialogue, or expression of views, which enables the process to be refined and cross-checked.

Jim Murphy: The hon. Gentleman raises, for the first time in our proceedings, this important point: a decision maker is not in place to second-guess the medical assessment of Atos Origin. The decision maker is a legal necessity, as the legal responsibility lies with them. The decision maker, when looking at the paperwork, might say, “Two contrary boxes have been ticked. This does not make sense. A procedure has not been followed,” after which they would go back to the assessor and ask more questions to probe further. The decision maker is in place to ensure that processes have been followed and that there is a robustness to the journey for the customer. They will then make their decision based on that.
It is important to say clearly that the decision maker has a legal responsibility, and that they have a responsibility to ensure that processes have been followed. They are not in place to overrule, in a medical sense, the recommendations from those who carry out the assessments.

Kali Mountford: My hon. Friend has just made an important point, but it brings into question what happens when two medical opinions directly contradict each other, particularly where conditions are more rare or less well understood. This might be a difficult area, although possibly a small one. Where a contradiction of opinion exists, how can it be properly ironed out to the satisfaction of the person who is being assessed?

Jim Murphy: That is another important point. On the revised PCA, the individual carrying out the assessment would ultimately make the judgment. You would not thank us for going through the whole customer journey again, Mr. Amess. Jobcentre Plus would initially ascertain whether it thought it was appropriate for the person to go for an assessment or whether they could immediately be admitted to the support group based on paper evidence. We would prefer that to be the route for most entering the support group. Ultimately, the decision as to the impact of that illness, ailment or condition on a person’s ability to undertake work-related activity or to work at all will be a decision of the person carrying out the assessment. All the evidence provided in writing and in the face-to-face interview would be taken into account. Ultimately, the person doing the assessment is the arbiter of all the different evidence. They will reach a conclusion and make a recommendation that will go to the decision maker. The customer, who will also increasingly have the right of reconsideration, will then have the right of appeal. Additional medical evidence—perhaps from their GP—will be heard on appeal.
As my hon. Friend acknowledges, it is important to make a distinction between the different medical views: a GP is there primarily to diagnose, rather than to assess the impact of the relevant condition on the customer’s ability to work. There will be two different medical practitioners for two different purposes. On appeal, the issue about which my hon. Friend is concerned could be raised.
We had a one-minute conversation about why the amendment is not technically necessary: because in our process there is a flexible power to amend training as is necessary. I encourage the hon. Member for Inverness, Nairn, Badenoch and Strathspey, who has been offered additional reassurance, to withdraw his amendment.

Danny Alexander: I am grateful for that detailed response. I take on board the Minister’s points about the legality of the amendments. However, I press him for clarity on three further points. Not wishing to try the Committee’s patience, I shall do so briefly. Some of what he said at the end of his remarks was important and needs to be teased out.
The Minister finished by discussing the role of the decision maker, an issue that could be brought up under a number of clauses. It may as well be dealt with now. During our last sitting, we discussed the process by which someone went from their assessment for limited capability to work to their assessment for limited capability for work-related activity and then, potentially, on to their work-focused health-related assessment. In a previous sitting, the Minister stated that a claimant is potentially sanctionable if they do not turn up for the work-focused health-related assessment and that the Government intended the claimant to take part in that assessment immediately after their assessments for limited capability for work and for work-related activity. That hangs crucially on the question of when the decision is taken and the decision about entitlement to the benefit support component, or whatever, is taken. If someone attending a first work-focused health-related assessment immediately after the other two assessments can be sanctioned at that point, that implies that the decision is taken when the Atos Origin doctor decides, not when the information goes to the decision maker to confirm, as the Minister said, that the process has been gone through properly and so on.
My point is important legally. Someone could be sanctioned following their decision not to participate in a work-focused health-related assessment because they believed that the decision as to whether they were entitled to the support component was wrong and they wished to appeal. I should be grateful for the Minister’s clarification on that point.

Tim Boswell: I understand the sensitivity of the hon. Gentleman’s point. Having reflected on the process at the weekend, I thought that it must be open to any claimant or customer, at any stage, to abort the process—or rather not allow the process to advance beyond the stage under consideration—unless and until a decision had formally been taken. In other words, if this is a test on limited capability for work, it would be open to the Department to say, “Without prejudice to this test and the formal decision on it, would you like to be considered for limited capacity for work-related activity?” However, it would be open to the individual to say, if they wished, “No, I want the issue out of the way. Then we can come back and consider any subsequent issues under later provisions”.

Danny Alexander: I am grateful for that intervention, with which I partly agree. I was convinced by the Minister’s previous remarks that it made sense for the assessments for the limited capability for work and for work-focused activity to take place at the same time, and that the break that the hon. Member for Daventry wants the claimant to have could legitimately take place after the assessment for limited capability for work benefit, and before the work-focused health-related assessment. The question whether one is entitled to the benefit is one of the criteria that is considered before a sanction can be applied. If someone has a work-focused health-related assessment immediately following that, but before a decision maker has taken the decision, that decision not to attend should not be sanctionable. I apologise for going into this matter now, but as we are following on from the Minister’s remarks about decision makers, I thought it was worth pursuing.
I have a couple of other quick points. The Minister gave a comprehensive list of training that Atos Origin doctors are required to undergo, which I found very encouraging. One thing that he did not mention was training on when it would be appropriate to bring in outside advice, in other words training on making decisions about whether to bring someone else in when the person making the assessment does not realise that he has reached the limit of his expertise. It is important that doctors can make that decision and that the decision maker, when looking at the file, can say that perhaps someone else should have been brought in and perhaps the procedure was not followed properly in that case.
An earlier point about the opportunity to bring these matters forward with Atos Origin concerned revisions of its contract. Will the Minister tell us whether that contract is being revised anyway in the context of the Disability Discrimination Act 1995? If so, does that provide an opportunity to make some of the points that we have been discussing in this important debate clearer?

Tim Boswell: In order to pave the way for the Minister’s response, does the hon. Gentleman agree that the Minister owes the Committee a moment of time on the use of logic-driven protocols as part of the process as against the by and large assessments which have perhaps applied in the past?

Danny Alexander: I am grateful for that intervention. The hon. Gentleman, with his usual degree of foresight, predicts the third point that I wish the Minister to address. The personal capability assessment works through logic-driven protocols and the logic-integrated medical assessment system. Some of the disability organisations and others who are involved in the consultative groups for the redesign of the personal capability assessment have been given only limited information about the LiMA computer system that is used to administer the assessment. It is therefore important to consider how it works.
Answers are prompted by questions about a person’s typical day, for example. That is a good way to have the conversation. I can fully accept that. Answers are inputted into the system using, wherever possible, pre-coded responses. When one asks about a typical day and certain responses come up the doctor is asked to fit the response into a pre-coded response. The pre-coded responses themselves are then linked tothe descriptors which are described in some detail in the documentation about the revised PCA. That link between the pre-coded responses and the descriptors is where the question about protocols is particularly important.
Will the Minister consider the following point? The stakeholder groups—I assume that they will continue to help manage the process of changing the assessment—should continue to be involved not just with the descriptors that are being used, but also with the operation of LiMA and its effectiveness. If possible the external stakeholders should be engaged in an ongoing basis in monitoring the effectiveness of LiMA so that we make sure that the link between the pre-coded responses and the descriptors continues to be valid and does not lead to decisions being made which perhaps the Government or the Committee would not intend to be made.

Jim Murphy: In seeking three specific points of clarification, the hon. Gentleman tempts us to reopen our entire debate. I will try to respond to those three specific areas. The first area was when and how the decision is formally taken and the relationship between that and the Atos Origin assessment. As we discussed in a previous debate, if someone attains the 15 points and is therefore entitled to ESA—we can have another competition as to whether that amounts to success or failure and that comes down to perceptions—and in the same interview someone meets one of the 46 descriptors that we have listed on page 18 of the draft regulations, then of course they would be in the support group. There would be no conditionality and there would be no requirement to undertake the work-focused health assessment.
If someone at that point says, “I do not want to be written off. I know that I have 15 points and I know that I meet one or two of the 46 descriptors but I still want to be in this system,” they would get the support group level of benefit, so they would have the higher rate of benefit. If they still wished to undertake the work-focused health assessment at that point they could do so. Regardless of what happens to them in that work-focused health assessment, if they do get closer to the labour market, based on the assessment that was undertaken by Atos Origin that they did have 15 points and did meet one of the descriptors, they would continue to receive that higher rate of benefit, as being part of the support group.
Where Atos Origin says that a person has 15 points and meets one or more of the 46 descriptors, the Atos Origin medical expert could then defer the work-focused health assessment. The decision maker would then examine all the paperwork. He is not there to second-guess the medical assessment of the medical expert from Atos Origin but simply to ensure that all of the procedures have been followed and that everything has been done within the laws that we agree on and the regulations that will be decided at a later point.
If the customer is told that they have the 15 points and are entitled to ESA but they do not meet any of the 46 descriptors and therefore they are not in a support group, they would be asked to undertakethe second interview for the work-focused health assessment. If the customer decided not to attend that interview there would be no sanction at that point. Any sanction, if appropriate, would be enacted at the point where a decision maker received the paperwork and the assessment took place. The customer would, of course, have the right of appeal as they have throughout this process on any decision that impacts on their level of benefits. I hope that reassures the hon. Gentleman.
Atos Origin does an important and technically difficult piece of work for us all and all of our constituents. They know as well as we do that in the past there have been problems with their systems and they have sought to resolve those. The figure for the number of complaints about Atos Origin is down to 0.3 per cent. We can continue to find ways to reduce that 0.3 per cent even further.
With regard to disability organisations getting access to LiMA, they are happy to share that methodology and information with the disability organisations and, if they wish, will be happy to organise demonstrations of how the system works and dry run some cases to ensure that there is greater understanding of the system.

Tim Boswell: The Minister has been very helpful in giving those assurances. May I take him back to something that he said a moment ago about the decision-making process when he tied the main function of the decision maker to ensuring that processes are correctly carried out? Let me rehearse with him some wider concerns, which might or might not apply to the decision maker. If, for example, there is an examining doctor and there appears to be a pattern building up of racial prejudice or a particular blind spot on some medical issue, would it be in the powers of the decision maker to have a conversation with the examining doctor about it? The conversation would not strictly be about the paperwork or the process. A skewing of the conclusions might give rise to concern, however, and it ought to be addressed or examined.

Jim Murphy: The hon. Gentleman raises an important point, but it is better if the management information systems rather than the decision maker pick up on the issue. Work is under way to ensure that the systems are designed to pick up on wide variations in outcomes that are based on common character traits or the circumstances of the individual customer. There are different ways of implementing and assessing the 15 points or the 46 descriptors. If there are differences at the extremes, whereby one medical assessor has a 95 per cent. outcome for access to the support group and another has none, something is happening, and it is for the management information systems to pick up on. I do not agree with the hon. Gentleman about the way in which we pick up on that important point, but it is important that we do so.

Danny Alexander: I am grateful to the Minister for those assurances, and I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 8 ordered to stand part of the Bill.

Clause 9

Limited capability for work-related activity

Danny Alexander: I beg to move amendmentNo. 152, in page 7, line 10, leave out first ‘is’ and insert
‘and such other matters as the Secretary of State may by regulation prescribe’.
I understand that there will be a clause stand part debate, so my remarks on the amendment will be brief. Its purpose is to probe the Government’s thinking about the test of limited capability for work-related activity. The regulations make it clear that exemption from conditionality—in other words, from membership of the support group—will be a purely medical decision, rather than one that introduces any other, for example, social factors. It will be a purely medical decision based on an assessment of whether someone meets any one of the 46 descriptors.
Other factors might be worthy of consideration, and it would be useful if the Minister explained in more detail why the exemption from conditionality for the support group is based solely on medical criteria. What is the conception underlying the way in which the support component has been created? The amendment seeks to introduce a power to allow other factors,such as caring responsibilities, to be taken into account. Could they be introduced to decisions about the support component? Although they are outsidethe descriptors, the amendment would allow for the introduction of a social model and take account ofthe wider barriers to employment that people in the support group might face. If such factors cannot be taken into account in considering someone’s entitlement to membership of the support group, will the regulations ensure that other matters such as caring responsibilities can be considered when deciding whether someone entitled to the work-related activity component will be subject to conditionality, whether that be membership of the support group or work-related activity?

Jim Murphy: I shall respond to the hon. Gentleman’s point; as he said, we might have a stand part debate—with your permission, Mr. Amess. As he knows, clause 9 provides that the question whether a person’s capability for work-related activity is limited by his physical or mental condition, and if so, whether the limitation would make it unreasonable to require him to undertake such activity, is to be determined in regulations. As the Committee knows, I published a draft of those regulations two weeks ago on the day when the Committee of Selection met.
Our belief that work is a right underpins much of the Committee’s deliberations and was behind the genesis of the Bill. However, we recognise that for some, work is simply not possible. The support group has been created for individuals whose functional limitation is such that it would be unreasonable to require them to engage in work-related activity. As I have said, and as hon. Members have mentioned, that will be based on falling under one of the 46 listed descriptors provided to the Committee in regulation 3 of the draft regulations. Other non-medical circumstances such as caring responsibilities might make it difficult for ESA customers to engage in work-focused interviews or undertake work-related activity, but it would not be appropriate to place such factors on a prescriptive list in the way that the hon. Gentleman suggests.
The Committee has been provided with a copy of the draft regulations on work-focused interviews, which will allow a personal adviser to defer an interview if he or she considers that it would not assist the person in question or be appropriate in the circumstances. Personal advisers will be able to take into account non-medical issues such as transport difficulties, caring responsibilities or bereavement when making a decision on deferrals. So although I could not give the hon. Gentleman much comfort in our earlier debate on what he described as a social model of assessment, I hope that the additional paperwork that has been provided reassures him that deferrals can take place on the bases that I have mentioned.

Jeremy Hunt: The Minister will know that 10 per cent. of the 6 million carers are themselves disabled. If I understand his logic correctly, he is saying that personal advisers will be able to take account of that situation when considering whether to defer the requirement of work-related activity. Will he put himself in the shoes of a disabled person who, for example, cares for a disabled child? Simply deferring the obligation to participate in such activity is not adequate for someone in that situation. They simply do not have time to work, and it would be completely unrealistic to expect them to do so. Is there no possibility of greater flexibility so that in such a situation a person’s obligation to participate could be put on hold more permanently?

Jim Murphy: The length of time taken to grant a deferral will be a matter for the personal adviser. We are not talking about a day, a week or a month; it could be much longer than that. I think that there is unanimity about the idea that—except on medical grounds relating to access to a support group, although even then, those involved would be entitled to volunteer—the state and the Government should not be able to write anyone off by accident or design. In the scenario described by the hon. Gentleman, a deferral could be very long term; it would not be a case of “Please come back tomorrow.” It would clearly be inappropriate to request that someone undertake a work-focused interview or work-related activity in that scenario or in many of the others of which we are aware from our constituencies. That would be counter-productive and would add to the difficulties that people were experiencing, rather than doing what the Bill and the regulations are intended to do, which is, where possible, to lift the difficulties that people experience in getting closer to the labour market. I hope that that reassures the hon. Gentleman.

Wayne David: The Minister will be aware that mental health organisations have expressed some concern about this issue. What might happen, for example, to an individual who had attempted to commit suicide? What flexibility might be introduced in those circumstances?

Jim Murphy: We are suggesting all sorts of flexibilities in the draft regulations, but we do not wish to be prescriptive and to say, “This is the exhaustive list.” I am not sure that this will enlighten my hon. Friend, but some of the provisions are taken from paragraph 35 of the current decision makers guide, and, even there, the list is not exhaustive. The guide refers to what constitutes a good cause for not meeting some of the conditionality in terms of, for example, medical appointments, caring responsibilities and religious adherence.
On the specific point about someone who has attempted suicide, my hon. Friend will accept that people attempt that dramatic act for all sorts of reasons, including low esteem and a sense of worthlessness. Although he is not suggesting this, others have suggested that we automatically passport into a support group everyone who has attempted suicide for whatever reason. Such people would not automatically be entitled to condition management, work-focused interviews and the chance to get closer to the labour market again. The Government have a sense that that is not the right way to support someone in those circumstances.
When the work-focused interview and work-related activity would add to the complications and the pressure that a person felt, there would of course be a deferral. However, it would be wrong to say that we should put everyone into the support group, regardless of the reason why they had attempted suicide, and particularly when the pressure on a person had built up because of long-term unemployment, material poverty, their perception of their wider role in the world and of their inability to support themselves and their family, and their sense of worthlessness. In cases where it would help, we need to afford such people the support of work-focused interviews to try to get them back to the labour market. In cases where it would not help, there would be a deferral, and we would not seek at any point to add to the difficulties that somebody already faced.

Danny Alexander: I am grateful to the Minister for that response and particularly for clarifying the circumstances in which a work-focused interview—and, therefore, the degree to which a person who is not in the support group is subject to conditionality—can be deferred. The Minister has introduced a valuable concept into the discussion, and we might wish to probe it in much more detail on further clauses. For the time being, however, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Danny Alexander: I beg to move amendmentNo. 153, in clause 9, page 7, line 37, at end insert
‘and the safeguards that shall be applied when determining such matters’.

David Amess: With this it will be convenient to discuss the following amendments: No. 155, in clause 10, page 8, line 27, after ‘failure’, insert
‘and the safeguards that shall be applied when determining such matters’.
No. 173, in clause 17, page 15, line 2, at end add—
‘(c) safeguards that shall be applied when determining such matters.’.
No. 260, in clause 17, page 15, line 2, at end add—
‘(4) The circumstances which may be prescribed in section 17(3)(b) should include, but need not be restricted to, the person’s mental or physical condition.’.

Danny Alexander: This group of amendments relates to safeguards and the power to determine what safeguards may apply. Amendment No. 153 concerns clause 9 and the other amendments relate to other clauses. They are designed to probe in more detail the Government’s intentions regarding the provision of safeguards, particularly in relation to clause 9 and the assessments of people’s capability for work-related activity.
Elsewhere in the benefits and social security system, variation is allowed in what Ministers consider to be “good cause”. By tabling my amendments and for the Committee’s benefit, I ask the Minister to explain in more detail certain points regarding, for instance, the acts or omissions to be covered, the judgment of acts or omissions being considered, particularly in relation to decisions about information provided by an individual, and the judgment of whether someone had good cause when unavailable for their limited capability for work-related activity assessment. Will that decision be left to the decision makers? To what extent is it envisioned that external contractors will have the power to exercise that judgment?
Other issues fall within the scope of the amendments. They relate to the period in which benefit claims for the support component can be backdated. For example, if someone has good cause for being unavailable for an assessment, or for not providing the required information in a timely fashion and, as a result, a period elapses longer than the 13 weeks envisioned, what will the rules be on the backdating of those claims, if it is decided eventually that that person is entitled to the support component?
Last week, we debated appeals and the need for an appeals process. The Minister was generally reassuring in his response in that debate. However, how will a case in which a decision about good cause has been made be treated in the appeals process? Again, if someone has good cause for any act or omission in relation to those assessments, to what extent will their right of appeal be affected? Would that right be unfettered? Indeed, will that person have the right of appeal against a decision that might suggest that they did not have good cause for an act or omission? I know that that sounds slightly technical, but it is important to clarify those points and so I look forward to the Minister’s response.

Jim Murphy: I think that the hon. Gentleman’s amendments are intended to probe the Government’s intentions, as he said, and I can reassure him on a specific point: if someone’s entitlement to a support group has been rejected on the basis that, on assessment, they failed to meet one of the 46 descriptors, but on appeal it is found that that decision was incorrect, the ESA entitlement at the support group level will of course be reinstated and backdated to the start of the 14th week—the end of the 13-week assessment period. I hope that that reassures him.
As the hon. Gentleman said, clause 9 gives us powers to make regulations treating customers as not having limited capability for work-related activity, if they have failed without good cause to provide information or undergo a medical examination that they were asked to attend. However, we recognise the importance of ensuring that customers are not unfairly penalised if they have good reason for failing to undertake such an assessment.
Current legislation relating to incapacity benefit sets out the matters to be taken into account when determining whether a customer has shown good cause for failure to attend a medical examination to assess incapacity for work. Published guidance provides advice to the Department’s decision makers—I have referred to that in response to an intervention bymy hon. Friend the Member for Caerphilly (Mr. David)—on the steps to be taken to establish whether there is good cause.
We intend to follow the same approach under ESA. The draft regulations under clause 9, which the Committee has seen, set out the matters to be taken into account when determining whether a customer has shown good cause. As I mentioned, it is not an exhaustive list, because such an approach would be impractical and would not allow us the opportunity to innovate and be flexible, either nationally or at a local level. As we introduce ESA, it is important that we are able to adjust what constitutes good cause based on our experiences both from pathways and, from 2008 onwards, from the national introduction of ESA.
Amendment No. 155 was tabled by the hon. Member for Inverness, Nairn, Badenoch and Strathspey. Regulations under clause 10, which we will come to next, will set out what matters are to be taken into account when determining whether a customer has shown good cause for failure to take part in a work-focused health-related assessment. They will include taking into account the nature of the customer’s disability and his state of health at the time. I alluded in a previous debate to the fact that customers will have a right of appeal to an independent tribunal against a decision that they failed to take part in a work-focused health-related assessment without good cause.
I turn to amendments Nos. 173 and 260. In clause 17, we are taking powers to disqualify a customer from ESA. I reassure the hon. Gentleman and others that there are already considerable safeguards in place as part of the disqualification decision-making process. First, a customer will be given the opportunity to explain why he has behaved in the way in which he has, and evidence will then be considered by the decision maker. The decision maker will also need to consider any other available evidence.
In considering the evidence, the decision maker will have to consider whether the customer has good cause for not complying, and must take into account certain prescribed factors and disregard others in accordance with the regulations. A decision maker will be able to take into account any factor that he considers relevant, including the state of a person’s mental and physical health. We follow the same practice under the current IB regime.
We recognise the particular difficulties that people with mental health conditions might face in complying with requests. We will ensure that a decision is not taken to penalise any person with a mental health condition or learning disability without contact having first been made with them, or their carer or healthcare team.
If the decision maker decides that a person is tobe disqualified, that person will, as I have already committed, have the right of appeal to an independent tribunal. I assure the Committee that there will be adequate training for our staff and that safeguards will be put in place, meaning that customers will always be given opportunities to explain their actions before any disqualification occurs. It is important to mention that. I hope that my comments reassure the hon. Gentleman on the specific points that he has raised.

Danny Alexander: The Minister has raised some points that we might want to take up in the debate on later clauses, but for the time being, I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Jeremy Hunt: I beg to move amendment No. 227, in clause 9, page 7, line 40, at end add—
‘(5) Regulations under subsection (1) shall—
(a) ensure the full programme of work focused interviews is offered to those in the support group who indicate a desire to take part in these aspects of the programme,
(b) not penalise those persons for failing to participate in these activities, and
(c) treat engagement in—
(i) part time work,
(ii) voluntary work,
(iii) training courses, and
(iv) community activities
as valid outcomes from the work focused interview process that would not automatically lead to a suspension of payment of the employment and support allowance.’.
The amendment is one of the most important that Conservative Members will ask the Committee to consider. I should remind hon. Members that the explanatory notes state that
“the Government’s intention is that those receiving the support component should be able to volunteer to take part in”
work-related activity
“if they wish to do so.”
Despite the Government’s best intentions, the Bill fails to offer a realistic option of work-related activity to the most severely disabled.
We have had discussions this morning about how eligibility for entry into the support group is decided. We talked about the 46 descriptors. I do not want to read them all out, but perhaps I may remind the Committee of one or two, just so that all hon. Members will have in mind who precisely is meant. The category, for example, entitled “Walking or moving on level ground” relates to people who are not able manually to propel a wheelchair
“more than 30 metres without repeatedly stopping, experiencing breathlessness or severe discomfort.”
“Manual dexterity” relates to someone who cannot
“pick up a £1 coin or equivalent with either hand.”
The category of “Continence” relates to someone with 
“no voluntary control over bowel evacuation”,
and the category on cleaning includes someone who cannot clean their own torso without receiving physical assistance from another person. The heading “Conveying food or drink to his mouth” includes someone who
“cannot convey food or drink to his mouth without receiving physical assistance from another person”.
Finally, as to learning disabilities and, potentially, mental illness, the list includes reference to someone who
“cannot initiate and sustain basic personal action, for example, the organisation and completion of a simple task, without regular prompting and supervision given by a person in the presence of the claimant”.
What we are really talking about, as the Minister has said many times, is someone who conforms to just one of the 46 descriptors. We are talking about people for whom it is unrealistic to expect that it will be easy to move towards a full-time job—people who might require massive amounts of coaching even to be able to get a part-time job. It may even never be realistic to expect them to go into full-time employment. We are therefore talking about not only the most vulnerable people but the people furthest from the labour market. 
I have said to the Committee before that the Opposition hope that the Bill can be as bold for members of the support group as it can for members of the work-related activity group. The Secretary of State confirmed the comments in the notes during the debate in the House on 24 July. He also said clearly that he wanted people in the support group to be able to
“access all the appropriate support available”—[Official Report, 24 July 2006; Vol. 449, c. 623.]
I should have been very happy with that statement if he had left off the word “available” and said that he wanted everyone in the group to be able to access all the appropriate support, but his use of that word gives rise to some concern. [Interruption.]—I hear mutterings from a sedentary position and I do not suggest that there was any intention to use words carefully, but I am concerned about whether the appropriate support will be available for people in the support group.
The amendment would simply ensure that the Bill lived up to the promises made by the Secretary of State. It would, first, make it a statutory obligation—not just a Government intention—for the work-related activity component to be available for members of the support group. It would clearly make participation voluntary, because the Committee has agreed that any sanctions or compulsions would be totally inappropriate for that group. However, to make the arrangement realistic, we must accept that the outcome of the work-related activity process for members of the support group may not be a full-time job. It could be a part-time job, or voluntary work. It could be going on a training course or involvement in community activities.
When we carefully observe this most vulnerable group, real concerns arise that the general tenor of the rest of the Bill could send conflicting signals. I shall just read a sentence from page 123 of the excellent book by the Child Poverty Action Group called“A Route out of Poverty?”
“We are concerned that the Government’s focus on the merits of paid work, which has dominated policy since 1997, makes people who are not in it feel worthless. Much more emphasis should be placed on the contribution and participation of disabled people, irrespective of their ability to access paid employment. Many disabled people work as volunteers or carers, or run service user groups, yet are deemed to be out of work because they are not being paid. The Green Paper with its focus on drawing people into employment may perpetuate entrenched stereotypes.”
If the Government are to deliver on their intentions for the support group, a variety of outcomes is essential for the pathways to work programme involving part-time work, voluntary work, community activities and education. Last week, the Minister said that he recognised that that could be the case for education, and that:
“Further education has played an enormous role, and will continue to do so, in supporting people from all sorts of backgrounds, particularly those with a disability and a fluctuating mental health condition.”—[Official Report, Standing Committee A 17 October 2006; c. 51.]
I think the Minister understands the direction ofmy thinking on these issues, but I have a couple of concerns. The first is whether the pathways programme has the necessary resourcing to provide adequate support for people on the support component. Citizens Advice, for example, said that it has
“great concerns that the £360 million will not be sufficient to provide the same level of support, and the same range of opportunities, currently available to clients in Pathways areas.”
It makes that comment about everyone, whether they go into a work-related activity group or the support group. If there is a resource constraint for people in the work-related activity group, which is the less resource-intensive of the two groups, it will be doubly the case for those in the support group.
Finance may be a consideration because every Government must operate within financial constraints and if finance is the reason, I should be grateful if the Minister would come clean and say so. It is important when considering the support group to avoid false economies when it comes to cost. Yesterday, I was in Sheffield visiting an excellent organisation called Dimensions UK. I met the chief executive, David Wolverson, who told me an interesting story about one of his clients—I shall call him Dave. Dave has learning difficulties and has twice tried to live independently, but failed. He had to have people sleeping in with him overnight but during an 18-month period, with coaching from Dimensions UK, he was weaned off the necessity of having someone sleeping in with him overnight. I am sure that that process was expensive, but it was a big lifestyle change for Dave, who said, “I have no bloody staff here, so I can have a party.” It was a big change for him not having to have someone sleeping in with him, but it was also a bit lonely for him and he needed a lot of support. The crucial point is that the cost of having sleep-in staff is well in excess of £150 a week, but the cost of what he has now—an on-call system—is only £7 a week. Helping and supporting people to live independently results in a huge reduction in cost to taxpayers.

Kali Mountford: That story is inspiring and the gentleman concerned is obviously inspirational. However, does the hon. Gentleman believe that it is practical and appropriate to allocate a sum of money to cover everyone who might be in a support group? Has he considered how that could be costed and has he also considered that there might be a better way in the voluntary and other sectors to support someone who is not yet ready even for a work-focused interview other than through a mechanistic approach under the Bill?

Jeremy Hunt: As ever, the hon. Lady makes an important point. I am not suggesting that the provisions under the support component of the Bill are the only solution or the only way forward for such people. I am concerned about simply putting a line in the explanatory notes saying that the work-related activity component will be very good, that we have seen how it works with the pathways programme and that anyone else with more severe disabilities can volunteer for it if they want. I am concerned that that does not give true access to people in that group. The point about disability is that if we want to move to equality for disabled people, we must be proactive. It is a question not simply of eliminating prejudice, as with racial discrimination, but of taking proactive steps that make equality a reality. There will not be no statutory right: the explanatory notes say that such provision is the Government’s intention. Saying that the most severely disabled people can volunteer to be part of the support group will not help them as much as they need to be helped.
I shall illustrate my point, because there is a particular issue about part-time work. For many of the most severely disabled people, the most realistic outcome of any effective programme is to go into part-time work. They may volunteer first, as a stepping-stone. If they can move into full-time work, it is likely that part-time work will be a vital stepping-stone.
Yesterday I met a cleaner with learning disabilities, but they will not be able to do a full-time cleaning job straight away, so they have started by doing a couple of days a week and seeing how it goes. The benefits system makes that very difficult, because the moment one gets a part-time job working mornings, for example, one risks losing one’s entire benefits package, which is scary. We are asking someone who is vulnerable anyway to take a huge risk. Add to that the fear that the job may not work out, and that they may not know about the linking rules, and we are making it difficult for them.
I am not arguing that part-time work has to be a valid outcome for all people who participate in pathways to work; I am asking whether the Government will consider making it a valid outcome of the programmes for people who go on to the support element. In their case, it might be the most realistic outcome and a stepping-stone to full-time work, too.
Last week I raised a concern that by giving members of the support group a higher level of benefit, which everyone present supports in principle, there may be a danger that people will not want to leave the support group, because moving into the work-related activity component could mean a reduction in their benefit. The Minister’s response was that
“we would say that the person could keep the higher rate of benefit so that there were no perverse incentives to stay in the support group: they can keep the higher rate of benefit without going through the conditionality.”—[Official Report, Standing Committee A, 17 October 2006; c. 66.]
However, on page 8 of the regulations, a case study of “Sarah”, who is on the support component, says:
“Her condition gradually improves, and...she is assessed as not having limited capability for work-related activity. This means she moves into the work-related activity group which has the effect of a small reduction in her benefit.”
The regulations appear directly to contradict the Minister’s assurance that people will be able to move from the support element to the work-related activity element. I may have misunderstood them, but I should be grateful for the Minister’s clarification.
With the amendment, I am saying it is important that, if we can, we use the Bill to give the same opportunities to people with severe disabilities, particularly people with learning disabilities, as we give everyone else. The paper, “Valuing People: A New Strategy for Learning Disability for the 21st Century” talks about getting 30 per cent. of people with learning disabilities into the labour market. The figure is currently much lower. In that spirit, I hope that we can amend the Bill, so that we have legislation giving those most vulnerable people the same opportunity to take the next step forward in their life as we seek to create for those people with less severe disabilities.

Natascha Engel: I shall make a brief speech this time rather than a long intervention. The comments of the hon. Member for South-West Surrey were interesting. Sheffield Dave seems to embody the purpose of the Bill. We should stop writing people off. We should stop using the list system—listing all the things that make one incapable of working—and look instead at what a person is capable of doing. Having someone front-ending the investment, so that Sheffield Dave can in the end sleep by himself and may one day take part in some kind of work-related activity, is exactly what we want to achieve. It is very important to keep that element of the Bill as it is.
The difference between the support group and the work-related activity group is also important. I do not want to pre-empt what the Minister may say in response, but one pay-off of the Bill for those who move to the support group is that they will get a much higher level of support and benefit. Everyone appreciates that those on benefit are poor. Fundamental to the Bill is the fact that we want to get people off benefit and into some kind of work or work-related activity, not only to make them better off financially but because it will enrich their life—just as Sheffield Dave’s life was enriched.

Jeremy Hunt: My point is precisely as the hon. Lady says, but I am concerned that the Bill will not achieve that. Those people put into the support element will receive a higher level of benefit. Is the hon. Lady not concerned that the aspirations that she and I have for that most vulnerable group will not be met unless a wide range of outcomes are permitted, and not only full-time employment?

Natascha Engel: The hon. Gentleman is absolutely spot on, but I return to the point that I made earlier. We are trying to provide an enormous range or menu of options, and not only through Jobcentre Plus. That is the gateway, but engaging all the volunteer and private sector organisations, as the hon. Gentleman saw in Sheffield, can help ensure that people’s capabilities, whatever they are able to do, are best identified and properly exploited. They can then go and do whatever it is that they are able to do and want to do. Once they are on that virtuous ladder, perhaps with support and training, and with the expertise accessed through the Jobcentre Plus gateway, they will be able to develop and engage more constructively in the labour market.
The bottom line is not to move every person now on incapacity benefit into work. That is a million miles away from what we are trying to achieve through the Bill. We want to give people support and the opportunity to move off benefits into some kind of work-related activity. It is important that we should use the phrase “work-related activity” rather than work; again, it is fundamental to our case. I look forward to the hon. Member for South-West Surrey withdrawing the amendment.

Danny Alexander: I am delighted, as always, to follow the hon. Member for North-East Derbyshire; her comments, shared by those on all sides, about not writing anyone off were absolutely right. We had a political discussion earlier about the point, but whatever the merits of the support offered by this or previous Governments, too many people have been written off for too long. It is important that we change that culture for good.
I am not convinced by the amendment—it is not exactly how I would seek to make the change—but the hon. Member for South-West Surrey none the less raises an important point. He and the hon. Member for North-East Derbyshire made it clear—I think it needs to be made clear in the Bill—that assistance such as work-focused interviews should be available to any member of the support group who wants it. That is the point that has been made in this debate. The Minister will correct me if I am wrong, but it is not made clear in the Bill, although it is made clear in his remarks, the explanatory notes and so on. The Bill could allow a less well disposed future Government, or this Government in one of their less well disposed frames of mind, to decide—

Natascha Engel: What interest would any Government, now or in the future, have in not enabling people in the support group to access work-related activities or anything else?

Danny Alexander: I find it difficult enough to get myself into the frame of mind of other political parties as it is, without wishing to speculate as to their future motives. I shall not follow the line of argument down which the hon. Lady invites me.
I would like it to be made clear in the Bill that the support available to anyone on the work-related activity component will be available also to anyone on the support component who wishes to access it, free from the conditionality regime that would apply to the work-related activity group. For reasons that have been mentioned, it is critical that that support be available, and I know that the Government intend to make it available. I am not querying the Minister’s good intentions, but that needs to be made more explicit.
That need is important particularly for the reason articulated by the hon. Member for South-West Surrey, which I have also mentioned to the Committee and probably will again: the amount of funding that has been allocated for the roll-out of pathways to work across the country. The Minister may feel a bit hamstrung, because he is doubtless engaged in debates with the Treasury on how much he should get for rolling out pathways in the comprehensive spending review. I share the concern expressed by Citizens Advice and others that the £360 million that has so far been allocated for the Bill will be insufficient even for dealing with the needs of new claimants, let alone those of people already on support who wish to access it in future. We do not even know whether all that money will be spent on the roll-out of pathways to work. In answering a question that I asked in the House, the Secretary of State could say only that the lion’s share—a term that I do not believe is defined by the Treasury—would be used for pathways to work.
I do not know where the statistic comes from, but surveys are often said to show that 1 million people who are currently on incapacity benefit wish to work. We do not know, and I would not wish to prejudge, how many of them will be entitled to the new support component when migration takes place. I would like to think that every one of those people who wished to access the help available under pathways to work would be able to do so straight away without any constraints on the availability of support. Will the Minister make clear the position on that matter?

David Ruffley: I do not wish to detain the Committee too long. We have had a good debate, but as my hon. Friend the Member for South-West Surrey said, this amendment is important to Her Majesty’s loyal Opposition. I wish to make two points and ask one question, all of which relate directly to the amendment.
We must refer to the evaluation by the Department for Work and Pensions of the experience of incapacity benefit personal advisers in pathways. The Department’s own research has found that some personal advisers have reported a worrying tension between the need to give tailored support to those who receive the support element and wish to volunteer for work-related activity and the desire to hit targets and get the “quick wins”. Those are the words in the Department’s report, Mr. Amess; you would not expect me to use pejorative language. The desire of an IBPA to help his client is logical and understandable, but at the same time he knows that he has targets to meet. The Department’s research reports in 2004 and 2005, each entitled “Incapacity Benefit Reforms—the Personal Adviser Role & Practices”, indicated a difference in how different personal advisers reacted to different clients. It was stated that there were variations
“in the extent to which IBPAs were willing to persist with...‘difficult’ customers.”
Sometimes they felt that they needed permission from their managers to spend extra time on what will be the support element segment of clients.
Amendment No. 227 argues for a regime where there is resourcing in respect of everyone in the support element who wishes to try work-related activity—my hon. Friend the Member for South-West Surrey mentioned that issue. The burden of my argument also relates to a cultural shift on the part of all personal advisers. This will extend to any advisers who work in the private sector or in not-for-profit charitable sector organisations who might deliver the roll-out of pathways and the new regime. Someone in the support component element would be under no obligation, because in the test in clause 9 they have demonstrated that they are further away from work, but they might want to make an effort and volunteer for work-related activity, even though the legislation does not require them to do so. They must be looked at through the prism that they should be supported and resourced. They should not be treated, as some of the evidence in these reports suggests they are being, as being more difficult to help—I would not use the term “easy wins”—where people say, “We will support those who are nearer the world of work and are more work ready.” I hate to use a colourful word, but there cannot be any apartheid between the support element and those in the work-related activity component.

Natascha Engel: I promise that this is my last intervention. I think that the hon. Gentleman misunderstands the concept of the support group. It is not a passive parking place for people who are more severely disabled or unable to work. It is an active group that will still be encouraged to move into the work-related activity group.

David Ruffley: I am grateful to the hon. Lady. I have not misunderstood the concept; the entire burden of the amendment argues for her point. Those in the support group must be encouraged more than ever before under the pathways and previous regimes to have the opportunity to access the work-related activities, which are the right of those in the work-related activity component. They are not a right in the same way for those in the support component, because under the conditionality they are not required to engage in work-related activity. I hope that she accepts that the provisions suggest that although the support component contains those who wish to migrate to the work-related activity component, it is not obvious that that will be fully resourced because it is voluntary. People might not want to do that—[Interruption.]
The Minister from a sedentary position talks about resourcing. That is the burden of the argument made by Citizens Advice and many other outside organisations: the £360 million for the roll-out of pathways to 2008 might not be enough to cater fully for all those in the support group who want to migrate on to the work-related activity, which is more resource-intensive, as we all know.

Jeremy Hunt: In response to the earlier intervention, no one is denying what the intention of the Bill is. Our concern is the practice, as I am sure my hon. Friend would agree. Does he agree that one of the particular causes of concern was the DWP’s own research in 2005 on personal advisers? The suggestion has been made that
“there is a danger that increasing the weight placed on early job entry targets in the future might lead them to focus on the ‘quick wins’ versus those who really benefit from the pilots.”
Are we not really arguing that we precisely do not want people in the support element of the component to end up being parked while the whole focus of people working to quite tight contracts is on getting people into jobs when that might not be an option?

David Ruffley: I am grateful for that intervention. We all agree here. It is a question of teasing out an understanding that the £360 million or perhaps even greater resources will be adequate to fund everyone in the support group who might want to volunteer for work-related activity, which, under the provision as drafted, they are under no obligation to do. An interesting question is how many will wish to volunteer for the work-related activity and whether that is resourced.
My final point relates to access to work. One of the many active labour market programmes that might be relevant to getting those in the support group to work-related activity and making it successful for them is access to work. This is not the place to have the debate about that very good programme, which is popular with those employers who know about it. I know that the Under-Secretary of State for Work and Pensions, who is responsible for that programme, understands what good value for money it represents in public spending terms. It is not just me saying that, but Citizens Advice, the Royal National Institute for the Blind and many others.
I have one question about access to work which bears on the amendment. It is my understanding that access-to-work funding is not available to those undertaking voluntary work. Voluntary work could be part of the work-related activity that support component customers might want to do. Therefore, those who wish to undertake such work-related activity seem to be at a disadvantage—access-to-work funding will not be available to them. I understand historically why that is the case, but if such funding is not available for those who want to go from the support component to work-related activity, can either Minister tell us whether there is anything commensurate to help them? Are there any pots of money and Government programmes that might meet the needs of people who wish to do voluntary activity, but who are not required to do it under the clause because they are in the support component? For them, an access to work-style programme may be particularly helpful.

Kali Mountford: I am grateful for the opportunity to make a short contribution. I am concerned about the amendment for a number of reasons. The hon. Member for Bury St. Edmunds rightly pointed out the fact that a cultural shift has taken place over a number of decades. To answer my hon. Friend the Memberfor North-East Derbyshire, there are different circumstances in which Governments may seek, for whatever reason, to use a group of unemployed people. During periods of high unemployment, low economic activity overall and general economic decline, it is not uncommon for Governments to use, to take a Marxist analysis, a reserve army of the work force. It is not an unfamiliar concept.
We have to look at how the cultural shift has come about and why it is important to revisit what we can do for people. We are in a different economic environment now and I hope that that will continue for many years. Nevertheless, circumstances change. The hon. Member for Bury St. Edmunds describes some people in some departments, some of whom might work in Jobcentre Plus and some in the voluntary sector, whose attitudes and approaches to clients have had to change in those periods. We cannot take a single day and say that it demonstrates how all people operate with all clients, because it simply is not true. From that point and following new experiences, people do change their approach to clients. That is a rather slow but necessary process.
We must also take into account the attitude of the people who are being assessed, in whose interests we are trying to form the legislation. Opposition Members have moved some way from what was deemed to be the proper way to deal with people, and I welcome the way in which they now look at things, but we have to be realistic and set measures in the context of the real world and what real people do.
The inspirational argument about “Sheffield Dave”, who will for ever more be known by that name, illustrates a certain point about how people can develop, but using the amendment as a way to deal with Sheffield Dave is problematic. On the one hand, we can say that the current system is providing for Sheffield Dave, although perhaps not for people in all places: it might be that Sheffield is particularly fortunate, or that some facilities are available in metropolitan areas but not in rural areas. That is another matter to consider. How on earth do we make exactly what is available in Sheffield available in Slaithwaite, the village where I live? Whether that would be the best way to spend resources is an argument that we could properly have, but what concerns me more is whether Slaithwaite Dave’s experience of life is the same as Sheffield Dave’s, and whether some people, unlike Sheffield Dave, have a longer journey to travel.
In my experience, if the Bill says simply that a right could be imposed, which sounds like a cosy and supportive way of dealing with things, people will soon think that they have a duty. When structuring legislation, we have to be careful to ensure that there are no unintended consequences.
Mr. Huntrose—

Kali Mountford: I can see that the hon. Gentleman is very eager, so I shall give way.

Jeremy Hunt: It seems to me that the hon. Lady is making an extremely eloquent argument in favour of the amendment, because I am saying precisely what she is saying: Sheffield Dave, Slaithwaite Dave and the myriad different people with varying disabilities need flexibility in the system. I do not think that I disagree with her, but I would put matters slightly differently. All those people want to make some progress towards being able to live independently, but everyone is starting at a different point in the journey, and it is important that the legislation should not foreclose options that might be vital stepping stones on the way to independent living, such as doing voluntary, community or part-time work. With the amendment, all that we seek to do is to make those possible outcomes of the pathway programme.

Kali Mountford: But the amendment would also mechanise the process, and that would not necessarily be helpful because some people are not even in that place yet. The whole idea is that putting oneself forward for support and help is the right way. The crux of the matter is the concept of someone deciding that they have reached a point at which they can accept support and can venture out and do something else with their lives. The amendment is well intended, but would have unintended consequences.
We have talked about the fact that the attitudes of people at officer level in the department or working in the voluntary sector have changed over the years, but there have been others with stagnant attitudes who have had to be pushed on a little. So it is for people with disabilities. Sometimes, they have to overcome similar attitudes, and if the amendment were accepted certain issues would rear up in their minds. Over the decades, constituents have said to me, “I feel as if pressure is being put on me now to do something I otherwise wouldn’t choose to do.”

Danny Alexander: I am listening carefully to the hon. Lady’s comments and she is making quite a profound point about people’s decision making, how they go about deciding whether to take part and at what point in their life they choose to avail themselves of whatever opportunities may be available. My point is that this is not about imposing a right that could easily be seen as an obligation on people. It is about making it clear that the obligation lies with the Government, who must ensure that, where someone makes the decision for themselves to come forward, the support available to the work-related activity group is also available to someone in the circumstances that the hon. Lady describes.

Kali Mountford: I am grateful that the hon. Gentleman at least understands my point; for that, many thanks. However, at many junctures in this debate, we have discussed how people make decisions and the information that they believe to be correct that is in fact incorrect. I think that this is one of those things that could be easily misunderstood and be detrimental to someone’s decision making.
Mr. Huntrose—

Kali Mountford: The hon. Gentleman is such a jack-in-the-box, how can I resist?

Jeremy Hunt: I am grateful to the hon. Lady for allowing me to jump up. I just want to remind her that paragraph (b) in the amendment specifically says that persons failing to participate in the activities could not be penalised. I completely agree with her, but let us put it more bluntly than she has. There may be people with disabilities or severe disabilities who are simply not ready to start engaging in the process of moving towards the world of work. That is a huge change. Sheffield Dave is an example of someone for whom just living independently, let alone working independently, was a huge step to take. The hon. Lady is right about that. There are also people who it is envisaged would be on the support component and desperately keen to take the next step towards the world of work. All the amendment is designed to do is to make some options open to them that may not otherwise be.

Kali Mountford: Again, I completely understandthe hon. Gentleman’s honourable intention with the amendment, but it is misplaced on this occasion. We have had many discussions about the sorts of things that people think they are required to do when in fact they are not. Simply stating, as paragraph (b) does, that there is no intention to penalise will not necessarily be the message that goes to people. The message may well go to them that there would be a duty. I prefer that people, through the entire process, decide for themselves and volunteer for help, rather than feeling as if it is somehow being imposed on them. We need to invest a great deal in people and we need to ensure that we focus that investment correctly, appropriately and adequately, but the amendment would not achieve what the hon. Gentleman believes it would.

Jim Murphy: In the time available before our interlude, I shall try to respond to the various points that have been made. I shall perhaps address at the start of our next sitting the more substantive points made by my hon. Friend and others.
The hon. Member for South-West Surrey said that this is one of the most important amendments that he has tabled in the proceedings thus far and perhaps will even be the most important in any of our 16 sittings in total. We can have a conversation in our next sitting about why he believes that, but I shall provide clarification now for him and therefore for others. It surprises us sometimes, but other people do read whatever is said here and therefore it is importantto correct the hon. Gentleman when he has unintentionally come to the wrong conclusion on case study 1 and Sarah. It is interesting that we have heard of case study Sarah, Sheffield Dave and Karl Marx all in one conversation.
In respect of case study 1, it is clear that the point is that Sarah’s condition gradually improves. It is not the fact that she volunteered but the fact that her condition improved that is relevant. That is why she would come out of the support group. If someone is in the support group and they volunteer, that does not prove to the Government that the decision to put them in the support group was wrong. It just shows that someone has a spark, a will, a determination, above what would be expected through the assessment, to try and to continue to try—

It being One o’clock, The Chairmanadjourned the Committee without Question put, pursuant to the Standing Order.

Adjourned till this day at Four o’clock.